The cohort of elderly age 75 and older, often referred to as the old-old, is growing rapidly and is becoming an increasingly important segment of society. The elderly appear to be at higher risk than are other age cohorts for oral soft tissue lesions, however, very little is known about the prevalence, distribution, or risk factors for oral soft tissue lesions in this group. Previous epidemiologic studies of oral lesions suffer from methodological problems that limit their usefulness. Among these problems are a variety of non-standard examiner training methods, the lack of examiner calibration and reliability assessment, inadequately described criteria for lesion diagnosis, and the lack of representative samples of the elderly. The proposed project will develop and implement a standardized method of training and calibrating dentist-examiners, and then use these examiners to conduct a population-based study to estimate the prevalence of oral soft tissue lesions among elderly people and to identify potential risk factors for these lesions. The specific aims are: 1) to develop a series of videodisc simulations to train dentist- examiners to validly and reliably identify selected oral soft tissue lesions for epidemiologic studies; 2) to develop a series of patient examination simulations of oral soft tissue lesions to assess the intra- and inter-examiner reliability among trained examiners; 3) to determine the prevalence of selected oral soft tissue lesions among a population of elderly people over age 79; and 4) to identify medical, psycho-social, dental, and behavioral risk factors for selected oral soft tissue lesions.